Short-term effects of two different recovery strategies on muscle contractile properties in healthy active men: A randomised cross-over study.

The aim of this study was to compare the immediate effects of cold-water immersion (CWI) and hot-water immersion (HWI) versus passive resting after a fatigue-induced bout of exercise on the muscle contractile properties of the Vastus Medialis (VM). We conducted a randomised cross-over study involving 28 healthy active men where muscle contractile properties of the VM wer recorded using Tensiomyography (TMG) before and after CWI, HWI or passive resting and up to one-hour post-application. The main outcomes obtained were muscle displacement and velocity of deformation according to limb size (Dmr and Vdr). Our results showed a significant effect of time (F(3.9,405) =32.439; p <0.001; η2p =0.29) and the interaction between time and temperature (F(7.9,405) =5.814; p <0.001; η2p=0.13) on Dmr but no for temperature alone (F(2,81) =2.013; p =0.14; η2p=0.04) while for Vdr, both time (F(5.2,486) =23.068; p <0.001 η2p = 0.22) and temperature (F(2,81) =4.219; p = 0.018; η2p= 0.09) as well as the interaction (F(10.4,486) =7.784; p <0.001; η2p =0.16) were found significant. Compared to CWI, HWI increased Dmr post-application and Vdr both post-application as well as 15 and 45' thereafter. These findings suggest that applying HWI could be a valid alternative to CWI to promote muscle recovery.

Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis: A case-control study.

Rheumatoid arthritis (RA) has been related to an impairment of the nutritional status. Body mass index (BMI) has been used but questions arise about how to properly evaluate nutritional status in RA patients. Few studies have evaluated it by dual-energy X-ray absorptiometry.In women with RA, to analyze:Case-control study including 89 women with RA. The control group was composed by 100 patients affected by non-inflammatory rheumatic disorders. Study variables included age, RA duration, history, activity and disability, and in relation to nutritional status: BMI, serum albumin (ALB), whole body DXA assessment, and skeletal muscle index (SMI).Mean age of patients was 62 ±â€Š8 years, mean duration of RA was 14 ±â€Š9 years, mean disease activity score (DAS28) was 3.7 ±â€Š1.4 and mean Health Assessment Questionnaire was 0.88 ±â€Š0.77. BMI was 27.43 ±â€Š5.16 Kg/m in patients and 27.78 ±â€Š3.98 Kg/m in controls (P: ns). ALB was within normal range in all patients.By whole body DXA, RA patients presented a statistically significant lower lean mass in all locations and lower fat mass in limbs than controls. Patients had a redistribution of fat mass to trunk. Lean mass directly correlated with fat mass.Neither BMI nor ALB correlated with DXA parameters.BMI, appendicular lean mass and SMI correlated inversely with disease duration. Trunk lean mass correlated inversely, and fat mass directly, with RA disability parameters.RA patients fulfilled criteria of sarcopenia in 44% of cases versus 19% of controls (P <.001). In RA patients, regarding SMI, BMI showed a high specificity to detect sarcopenia (94% of the patients with low BMI had sarcopenia) but low sensitivity (47% of the patients with normal BMI or overweight had sarcopenia).RA patients have an impairment of nutritional status associated to disease duration that looks like sarcopenia and that is not predicted by BMI.

Testing an AAC system that transforms pictograms into natural language with persons with cerebral palsy.

In this article, we describe a compansion system that transforms the telegraphic language that comes from the use of pictogram-based augmentative and alternative communication (AAC) into natural language. The system was tested with four participants with severe cerebral palsy and ranging degrees of linguistic competence and intellectual disabilities. Participants had used pictogram-based AAC at least for the past 30 years each and presented a stable linguistic profile. During tests, which consisted of a total of 40 sessions, participants were able to learn new linguistic skills, such as the use of basic verb tenses, while using the compansion system, which proved a source of motivation. The system can be adapted to the linguistic competence of each person and required no learning curve during tests when none of its special features, like gender, number, verb tense, or sentence type modifiers, were used. Furthermore, qualitative and quantitative results showed a mean communication rate increase of 41.59%, compared to the same communication device without the compansion system, and an overall improvement in the communication experience when the output is in natural language. Tests were conducted in Catalan and Spanish.

Lung transplantation in systemic sclerosis: A single center cohort study.

OBJECTIVE: Lung transplantation (LT) has been proposed as a treatment for advanced interstitial lung disease (ILD) and/or pulmonary hypertension (PH) associated to systemic sclerosis (SSc) but few studies have been reported. The aim of this study was to describe the clinical features, complications and survival of a single-center cohort of patients with SSc that underwent LT and to compare their survival with a group of non-SSc transplanted patients. METHODS: Fifteen patients with SSc were transplanted between May 2005 and April 2015. Standard international criteria were used to determine eligibility for LT. The severity of gastroesophageal involvement was not considered as a major contraindication if symptoms were under control. RESULTS: Eight (53.3%) patients had diffuse cutaneous SSc. Eleven (73%) underwent bilateral LT. The main indication for LT was ILD, with or associated PH in 4 cases. Acute cellular rejection and infections were the most frequent complications. Functional lung tests tended to keep stable after transplantation. Median survival was 2.4 years (Q1-Q3: 0.7-3.7 years). We did not find differences in survival between patients transplanted with SSc versus those transplanted due to non-SSc ILD or PH. SSc complications were scarce with no patient developing PH after LT. CONCLUSIONS: LT was an effective treatment for advanced ILD and/or PH associated to SSc in our study. Gastroesophageal reflux was not a limitation for LT in SSc in this study. Complications and survival did not differ from non-SSc patients undergoing LT.

Influence of early neurological complications on clinical outcome following lung transplant.

BACKGROUND: Neurological complications after lung transplantation are common. The full spectrum of neurological complications and their impact on clinical outcomes has not been extensively studied. METHODS: We investigated the neurological incidence of complications, categorized according to whether they affected the central, peripheral or autonomic nervous systems, in a series of 109 patients undergoing lung transplantation at our center between January 1 2013 and December 31 2014. RESULTS: Fifty-one patients (46.8%) presented at least one neurological complication. Critical illness polyneuropathy-myopathy (31 cases) and phrenic nerve injury (26 cases) were the two most prevalent complications. These two neuromuscular complications lengthened hospital stays by a median period of 35.5 and 32.5 days respectively. However, neurological complications did not affect patients' survival. CONCLUSIONS: The real incidence of neurological complications among lung transplant recipients is probably underestimated. They usually appear in the first two months after surgery. Despite not affecting mortality, they do affect the mean length of hospital stay, and especially the time spent in the Intensive Care Unit. We found no risk factor for neurological complications except for long operating times, ischemic time and need for transfusion. It is necessary to develop programs for the prevention and early recognition of these complications, and the prevention of their precipitant and risk factors.

BALF cytokines in different phenotypes of chronic lung allograft dysfunction in lung transplant patients.

The long-term success of lung transplantation (LT) is limited by chronic lung allograft dysfunction (CLAD). Different phenotypes of CLAD have been described, such as bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). The purpose of this study was to investigate the levels of cytokines and chemokines in bronchoalveolar lavage fluid (BALF) as markers of these CLAD phenotypes. BALF was collected from 51 recipients who underwent (bilateral and unilateral) LT. The study population was divided into three groups: stable (ST), BOS, and RAS. Levels of interleukin (IL)-4, IL-5, IL-6, IL-10, IL-13, tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were measured using the multiplex technology. BALF neutrophilia medians were higher in BOS (38%) and RAS (30%) than in ST (8%) (P=.008; P=.012). Regarding BALF cytokines, BOS and RAS patients showed higher levels of INF-γ than ST (P=.02; P=.008). Only IL-5 presented significant differences between BOS and RAS (P=.001). BALF neutrophilia is as a marker for both CLAD phenotypes, BOS and RAS, and IL-5 seems to be a potential biomarker for the RAS phenotype.

Influence of right ventricular function on the development of primary graft dysfunction after lung transplantation.

BACKGROUND: Primary graft dysfunction (PGD) remains a significant cause of lung transplant postoperative morbidity and mortality. The underlying mechanisms of PGD development are not completely understood. This study analyzed the effect of right ventricular function (RVF) on PGD development. METHODS: A retrospective analysis of a prospectively assessed cohort was performed at a single institution between July 2010 and June 2013. The primary outcome was development of PGD grade 3 (PGD3). Conventional echocardiographic parameters and speckle-tracking echocardiography, performed during the pre-transplant evaluation phase up to 1 year before surgery, were used to assess preoperative RVF. RESULTS: Included were 120 lung transplant recipients (LTr). Systolic pulmonary arterial pressure (48 ± 20 vs 41 ± 18 mm Hg; p = 0.048) and ischemia time (349 ± 73 vs 306 ± 92 minutes; p < 0.01) were higher in LTr who developed PGD3. Patients who developed PGD3 had better RVF estimated by basal free wall longitudinal strain (BLS; -24% ± 9% vs -20% ± 6%; p = 0.039) but had a longer intensive care unit length of stay and mechanical ventilation and higher 6-month mortality. BLS ≥ -21.5% was the cutoff that best identified patients developing PGD3 (area under the receiver operating characteristic curve, 0.70; 95% confidence interval, 0.54-0.85; p = 0.020). In the multivariate analysis, a BLS ≥ -21.5% was an independent risk factor for PGD3 development (odds ratio, 4.56; 95% confidence interval, 1.20-17.38; p = 0.026), even after adjusting for potential confounding. CONCLUSIONS: A better RVF, as measured by BLS, is a risk factor for severe PGD. Careful preoperative RVF assessment using speckle-tracking echocardiography may identify LTrs with the highest risk of developing PGD.

Trasplante pulmonar en la fibrosis pulmonar idiopática y otras enfermedades pulmonares intersticiales / Lung transplantation in pulmonary fibrosis and other interstitial lung diseases

Fundamento y objetivo: Las enfermedades pulmonares intersticiales (EPI) constituyen, después del enfisema, la segunda indicación de trasplante pulmonar (TP). El objetivo del presente estudio es la revisión de los resultados del TP en la EPI en el Hospital Vall d’Hebron (Barcelona). Pacientes y método: Se estudian retrospectivamente 150 pacientes, 87 (58%) varones, con una edad media de 48 años (extremos 20-67), en los que se indicó un TP por una EPI entre agosto de 1990 y enero de 2010, y que representan el 30% del total de TP (150/496) realizados en Cataluña. Ciento cuatro (69%) fueron trasplantes unipulmonares (TUP), y 46 (31%), trasplantes bipulmonares (TBP). Los diagnósticos postoperatorios fueron: 94 (63%) neumonía intersticial usual, 23 (15%) neumonía intersticial no específica, 11(7%) neumonía intersticial no clasificable y un 15% miscelánea. Se describen los resultados funcionales, las complicaciones y la supervivencia. Resultados: La supervivencia actuarial fue del 87, 70 y 53% a uno, 3 y 5 años, respectivamente. Las causas de muerte más frecuentes incluyen la disfunción precoz del injerto y el desarrollo de rechazo crónico en forma de bronquiolitis obliterante (BOS). El incremento medio postoperatorio de la capacidad vital forzada y del forced expiratory volume in the first second (FEV1, «volumen espiratorio forzado en el primer segundo») fue similar en el TUP y el TBP. El mejor FEV1 posterior al TP se alcanzó al décimo mes (extremos 1-36). El 16% de los pacientes se reintegró al trabajo. En algún momento de la evolución se diagnosticó rechazo agudo, confirmado histológicamente en 53 (35%) pacientes. La prevalencia de BOS entre los supervivientes fue del 20% al año, 45% a los 3 años y del 63% a los 5 años. Conclusión: El TP es hasta ahora el único tratamiento capaz de alargar la vida de los pacientes con EPI avanzada y en nuestro medio ha permitido que uno de cada 6 pacientes haya vuelto a trabajar. Sin embargo, el rechazo crónico sigue siendo el principal problema a resolver en el futuro (AU)

Background and objective: Interstitial lung disease (ILD) is the second indication for lung transplantation (LT) after emphysema. The aim of this study is to review the results of LT for ILD in Hospital Vall d’Hebron (Barcelona, Spain). Patients and methods: We retrospectively studied 150 patients, 87 (58%) men, mean age 48 (r: 20-67) years between August 1990 and January 2010. One hundred and four (69%) were single lung transplants (SLT) and 46 (31%) bilateral-lung transplants (BLT). The postoperative diagnoses were: 94 (63%) usual interstitial pneumonia, 23 (15%) nonspecific interstitial pneumonia, 11 (7%) unclassifiable interstitial pneumonia and 15% miscellaneous. We describe the functional results, complications and survival. Results: The actuarial survival was 87, 70 and 53% at one, 3 and 5 years respectively. The most frequent causes of death included early graft dysfunction and development of chronic rejection in the form of bronchiolitis obliterans (BOS). The mean postoperative increase in forced vital capacity and forced expiratory volume in the first second (FEV1) was similar in SLT and BLT. The best FEV1 was reached after 10 (r: 1-36) months. Sixteen percent of patients returned to work. At some point during the evolution, proven acute rejection was diagnosed histologically in 53 (35%) patients. The prevalence of BOS among survivors was 20% per year, 45% at 3 years and 63% at 5 years. Conclusions: LT is the best treatment option currently available for ILD, in which medical treatment has failed (AU)

Direcciones futuras en el trasplante pulmonar / Future Directions in Lung Transplant

No disponible

[Lung transplantation in pulmonary fibrosis and other interstitial lung diseases]. / Trasplante pulmonar en la fibrosis pulmonar idiopática y otras enfermedades pulmonares intersticiales.

BACKGROUND AND OBJECTIVE: Interstitial lung disease (ILD) is the second indication for lung transplantation (LT) after emphysema. The aim of this study is to review the results of LT for ILD in Hospital Vall d'Hebron (Barcelona, Spain). PATIENTS AND METHODS: We retrospectively studied 150 patients, 87 (58%) men, mean age 48 (r: 20-67) years between August 1990 and January 2010. One hundred and four (69%) were single lung transplants (SLT) and 46 (31%) bilateral-lung transplants (BLT). The postoperative diagnoses were: 94 (63%) usual interstitial pneumonia, 23 (15%) nonspecific interstitial pneumonia, 11 (7%) unclassifiable interstitial pneumonia and 15% miscellaneous. We describe the functional results, complications and survival. RESULTS: The actuarial survival was 87, 70 and 53% at one, 3 and 5 years respectively. The most frequent causes of death included early graft dysfunction and development of chronic rejection in the form of bronchiolitis obliterans (BOS). The mean postoperative increase in forced vital capacity and forced expiratory volume in the first second (FEV1) was similar in SLT and BLT. The best FEV1 was reached after 10 (r: 1-36) months. Sixteen percent of patients returned to work. At some point during the evolution, proven acute rejection was diagnosed histologically in 53 (35%) patients. The prevalence of BOS among survivors was 20% per year, 45% at 3 years and 63% at 5 years. CONCLUSIONS: LT is the best treatment option currently available for ILD, in which medical treatment has failed.

Relationship between psoriatic arthritis and moderate-severe psoriasis: analysis of a series of 166 psoriatic arthritis patients selected from a hospital population.

The aim of the study was to assess the prevalence of moderate to severe psoriasis (MS-P) in patients with psoriatic arthritis (PsA) and the relationship between MS-P and other variables related to arthritis. One hundred sixty-six consecutive patients with PsA periodically monitored at a university hospital's PsA unit in northeastern Spain were included in the study. Patients with psoriasis were classified as having MS-P when systemic treatment for skin was required. Clinical criteria for treatment indication was BSA >10 and/or PASI >14 and/or psoriasis affecting a very sensitive area of the body. Demographic and clinical data related to arthritis were assessed, including PsA pattern, age of onset of psoriasis and arthritis, disease activity index, and treatment required over the course of the disease. Moderate-severe psoriasis were more prevalent in women (p = 0.027). One hundred nine patients (65.7%) had psoriatic nail disease, and MS-P was more frequent in these patients (40 (77%) vs. 69 (61%), p = 0.028). Patients with spondyloarthropathy were significantly associated with MS-P (7 (16%) vs. 3 (3%), p = 0.014). No statistical association was observed between severe psoriasis and the age of onset of psoriasis or arthritis, involvement of distal interphalangeal joints, laboratory findings (HLA B27, RF), functional class, or disease activity indices. We report a high prevalence of severe psoriasis among patients with psoriatic arthritis, higher in women and patients with psoriatic nail disease and axial spondyloarthropathy.

Normativa para la selección de pacientes candidatos a trasplante pulmonar / Guidelines for the Selection of Lung Transplantation Candidates

La presente normativa ha sido elaborada con el consenso de, al menos, un representante de cada uno delos hospitales con programa de trasplante pulmonar en España. Además, previamente a su publicación,ha sido revisada por un grupo de revisores destacados por su reconocida trayectoria en el campo del trasplantepulmonar. En las siguientes páginas, el lector encontrará los criterios de selección de pacientescandidatos a trasplante pulmonar, cuándo y cómo remitir un paciente a un centro trasplantador y, finalmente,cuándo incluir al paciente en lista de espera. Se ha atribuido un nivel de evidencia a las cuestionesmás relevantes. Este documento pretende ser una guía práctica para los neumólogos que no participandirectamente en el trasplante pulmonar pero que deben considerar este tratamiento para sus pacientes.Finalmente, se ha propuesto de una forma consensuada un documento que recoge de forma estructuradalos datos del paciente potencial candidato a trasplante pulmonar que son relevantes para poder tomar lamejor decisión(AU)

The present guidelines have been prepared with the consensus of at least one representative of eachof the hospitals with lung transplantation programs in Spain. In addition, prior to their publication,these guidelines have been reviewed by a group of prominent reviewers who are recognized for theirprofessional experience in the field of lung transplantation. Within the following pages, the reader willfind the selection criteria for lung transplantation candidates, when and how to remit a patient to atransplantation center and, lastly, when to add the patient to the waiting list. A level of evidence hasbeen identified for the most relevant questions. Our intention is for this document to be a practical guide for pulmonologists who do not directly participate in lung transplantations but who should consider thistreatment for their patients. Finally, these guidelines also propose an information form in order to compilein an organized manner the patient data of the potential candidate for lung transplantation, which arerelevant in order to be able to make the best decisions possible(AU)

Guidelines for the selection of lung transplantation candidates.

The present guidelines have been prepared with the consensus of at least one representative of each of the hospitals with lung transplantation programs in Spain. In addition, prior to their publication, these guidelines have been reviewed by a group of prominent reviewers who are recognized for their professional experience in the field of lung transplantation. Within the following pages, the reader will find the selection criteria for lung transplantation candidates, when and how to remit a patient to a transplantation center and, lastly, when to add the patient to the waiting list. A level of evidence has been identified for the most relevant questions. Our intention is for this document to be a practical guide for pulmonologists who do not directly participate in lung transplantations but who should consider this treatment for their patients. Finally, these guidelines also propose an information form in order to compile in an organized manner the patient data of the potential candidate for lung transplantation, which are relevant in order to be able to make the best decisions possible.

Una tarea para evaluar la agudeza visual dinámica y una valoración de la estabilidad de sus mediciones / No disponible

Apenas existen instrumentos de medición adecuados de la capacidad paradiscriminar estímulos en movimiento, cuya aplicación resulte fácil y cuyasvaloraciones sean estables a través del tiempo. También se constata laausencia de un paradigma de evaluación que se muestre sensible anteaquellos factores que, en estudios previos, han sido relacionados con lavisión dinámica. En consecuencia, nos proponemos como objetivo diseñaruna tarea que permita la valoración de la agudeza visual dinámica (AVD),definida como la capacidad de discriminar detalles en condiciones demovimiento relativo entre sujeto y objeto. Para ello, hemos realizado dosestudios psicofísicos. El primero muestra que la AVD resulta modulada portres factores: velocidad, contraste y trayectoria del estímulo móvil,interaccionando significativamente los dos primeros. En el segundo estudio,hemos averiguado la correlación entre la AVD obtenida por los sujetos entres momentos separados, al menos, una semana (t1 y t2) y entre, al menos,dos semanas (t2 y t3). Estas oscilaron entre 0,78-0,92, para una velocidad de14,1º/seg. y entre 0,72-0,85 para una velocidad de 1,4º/seg. Finalmente,comparamos las valoraciones de AVD en esos tres momentos, noencontrando diferencias significativas en el factor temporal. Concluimosque, nuestra tarea constituye una herramienta objetiva, y de fácil aplicacióntanto clínica como experimental, muy útil para valorar la AVD(AU)

Feasibility, tolerability, and outcomes of nebulized liposomal amphotericin B for Aspergillus infection prevention in lung transplantation.

BACKGROUND: Nebulized amphotericin B deoxycholate (n-ABD) is used to prevent Aspergillus infection in lung transplantation. Nebulized liposomal amphotericin B (n-LAB) is another option; however, no clinical data are available on the results of n-LAB for this purpose. METHODS: In an observational study performed in 2 centers to assess the feasibility, tolerability, and outcomes of n-LAB prophylaxis, 104 consecutive patients undergoing prophylaxis with n-LAB were compared with 49 historical controls who received n-ABD. Patient follow-up lasted 12 months. The n-LAB prophylaxis regimen was 25 mg thrice weekly starting on the first post-operative day and continuing to 60 days, 25 mg once weekly from 60 to 180 days, and the same dose once every 2 weeks thereafter. RESULTS: Aspergillus infection developed in 8 of 104 patients (7.7%) with n-LAB prophylaxis (5 colonization, 1 simple tracheobronchitis, 1 ulcerative tracheobronchitis, and 1 invasive pulmonary infection). Ulcerative tracheobronchitis and invasive pulmonary aspergillosis were regarded as invasive disease; hence, the rate of invasive disease was 1.9% (2 patients). The control group had similar rates of Aspergillus infection (10.2%; p = 0.6) and invasive disease (4.1%; p = 0.43). In 3 patients (2.9%), n-LAB was withdrawn due to bronchospasm in 2 and nausea in 1. In the control group, prophylaxis was stopped in 2 patients (4.1%) because of bronchospasm (p = 0.7). CONCLUSIONS: At the dose and frequency described, n-LAB seems effective, safe, and convenient for the prevention of Aspergillus infection in lung transplant patients.

Trasplante bipulmonar en hipertensión pulmonar. Una serie de 15 pacientes / Double-lung Transplantation in 15 Patients With Pulmonary Hypertension

IntroducciónLa hipertensión pulmonar (HP) es una enfermedad grave tributaria de trasplante pulmonar (TP) en su fase terminal.Pacientes y métodosSe ha realizado un estudio retrospectivo de 15 pacientes con HP, a los que se trató con un TP en el período 1994–2004. Se revisan los datos clínicos antes del trasplante y el seguimiento tras éste.ResultadosEn 8 pacientes (53%) la HP fue idiopática y en 2 estuvo relacionada con el consumo de aceite tóxico; el resto de etiologías, con un paciente cada una, fueron: embolia pulmonar crónica periférica, histiocitosis X, enfermedad venooclusiva, esclerodermia y cardiopatía congénita simple corregida. Los valores hemodinámicos medios fueron: presión arterial pulmonar sistólica, diastólica y media, 100; 50, y 67mmHg, respectivamente; gasto cardíaco, 2,63l/min; resistencia pulmonar total, 20,9 UW. El tiempo desde el diagnóstico de HP hasta el TP fue de 5,9 (rango: 0,4-20) años. Siete pacientes estaban en clase funcional III y 8 en clase funcional IV. La distancia media recorrida en la prueba de la marcha de 6min fue de 204m (rango: 0–360). La mortalidad perioperatoria fue de 4 pacientes (26%). La supervivencia a 1; 3, y 5 años fue de 9 (60%), 7 (46%) y 6 (40%) pacientes, respectivamente.ConclusionesEl TP bilateral es una opción terapéutica que, en casos seleccionados, presenta resultados comparables al tratamiento médico más activo de la HP(AU)

BackgroundPulmonary hypertension is a serious disease that, in its terminal phase, requires lung transplantation.Patients and methodsA retrospective study was undertaken of 15 patients with pulmonary hypertension who underwent lung transplantation between 1994 and 2004. Clinical data recorded before the procedure and during follow-up were reviewed.ResultsPulmonary hypertension was reported as idiopathic in 8 patients (53%) and related to consumption of toxic oil in 2. The remaining causes were documented as chronic peripheral pulmonary embolism, histiocytosis X, venoocclusive disease, scleroderma, and simple corrected congenital heart defect in 1 patient each. The mean values of the hemodynamic variables were 100, 50, and 67mm Hg for systolic, diastolic, and mean pulmonary artery pressure, respectively; 2.63L/min for cardiac output; and 20.9 Wood units for total pulmonary resistance. The mean time between diagnosis of pulmonary hypertension and lung transplantation was 5.9 years (range, 0.4–20 y). Seven patients were in functional class III and 8 in functional class IV. The mean 6-minute walk distance was 204m (range, 0–360m). Four patients (26%) died during the during the perioperative period and 9 (60%), 7 (46%), and 6 (40%) were still alive at 1, 3, and 5 years, respectively.ConclusionsDouble-lung transplantation is a therapeutic option that, in certain cases, has similar outcomes to those achieved with the most aggressive medical treatment for pulmonary hypertension(AU)

[Double-lung transplantation in 15 patients with pulmonary hypertension]. / Trasplante bipulmonar en hipertensión pulmonar. Una serie de 15 pacientes.

BACKGROUND: Pulmonary hypertension is a serious disease that, in its terminal phase, requires lung transplantation. PATIENTS AND METHODS: A retrospective study was undertaken of 15 patients with pulmonary hypertension who underwent lung transplantation between 1994 and 2004. Clinical data recorded before the procedure and during follow-up were reviewed. RESULTS: Pulmonary hypertension was reported as idiopathic in 8 patients (53%) and related to consumption of toxic oil in 2. The remaining causes were documented as chronic peripheral pulmonary embolism, histiocytosis X, venoocclusive disease, scleroderma, and simple corrected congenital heart defect in 1 patient each. The mean values of the hemodynamic variables were 100, 50, and 67 mm Hg for systolic, diastolic, and mean pulmonary artery pressure, respectively; 2.63 L/min for cardiac output; and 20.9 Wood units for total pulmonary resistance. The mean time between diagnosis of pulmonary hypertension and lung transplantation was 5.9 years (range, 0.4-20 y). Seven patients were in functional class III and 8 in functional class IV. The mean 6-minute walk distance was 204 m (range, 0-360 m). Four patients (26%) died during the during the perioperative period and 9 (60%), 7 (46%), and 6 (40%) were still alive at 1, 3, and 5 years, respectively. CONCLUSIONS: Double-lung transplantation is a therapeutic option that, in certain cases, has similar outcomes to those achieved with the most aggressive medical treatment for pulmonary hypertension.